Responsible to: Locality GP Lead & Operational Services manager
Job Summary
We are looking for a motivated and experienced Advanced Nurse Practitioner to lead our Frail Elderly Assessment Team (FEAT). This is an exciting opportunity to deliver high quality patient-centered care to frail patients in their own homes and in our care homes.
The role combines clinical leadership, autonomous practice, care coordination, multi-agency collaboration, management of increasing frailty, dementia and end of life care.
The postholder will work at an advanced level of clinical practice, exercising a high degree of professional autonomy and accountability while working within the NMC code and national ANP frameworks.
Main Duties and Responsibilities
Lead the FEAT and champion evidence-base interventions
Conduct comprehensive geriatric assessments using appropriate tools
Monitor medication use and adjust treatment plans as required, autonomously working within scope of practice and in line with prescribing competencies.
Exercise advanced clinical reasoning to diagnose, treat, and manage patients without direct input from a medical practitioner, recognising own professional boundaries and seeking senior clinical support when required.
Provide expert management of frailty syndromes, dementia, delirium, polypharmacy, falls risk and end of life needs.
Escalate concerns appropriately and initiate urgent or emergency interventions when required.
Identify when clinical presentations fall outside of scope of practice and escalate appropriately to GP or senior clinicians.
Work closely with GP's, Occupational Therapists, Physiotherapists, Care Co-ordinators, Social Prescribers and Community Nursing Team
Attend and lead the MDT meetings and case reviews
Support patients and families in understanding and managing frailty
Promote lifestyle and self - management strategies to optimise health and independence
Functions at a high level to carry out clinical decision making such as diagnosing and managing patients without input from a medical practitioner remaining within scope of a professional practice.
Functions at a high level in relation to communication skills through patient consultation and nursing assessment of physical, psychological and social needs.
Completing proactive, individualised clinical management plans for care home residents improving their health experience and reducing unnecessary and potentially harmful hospital admissions
Conduct regular care plan reviews
Identify patients in need of palliative support and facilitate advanced care planning discussions with patients and families
Communicating with distressed/anxious/worried patients and relatives
Caring for patients and relatives following receipt of bad news and supporting them in identifying realistic expectations in relation to clinical conditions
Communicating and caring for patients who have reduced understanding and insight due to cognitive impairments
Participate/lead weekly enhanced care home reviews
Undertake daily acute care home visits requested through our clinical triage system identifying clinical emergencies, deteriorating patients or patients at risk of deterioration ensuring appropriate action
Participate in regular clinical supervision, reflective practice and case-based discussions to maintain safe, effective and autonomous practice.
Confidentiality:
In the course of seeking treatment, patients entrust us with, or allow us to gather, sensitive information in relation to their health and other matters. They do so in confidence and have the right to expect that staff will respect their privacy and act appropriately.
In the performance of the duties outlined in this , the post-holder may have access to confidential information relating to patients and their carers, Practice staff and other healthcare workers. They may also have access to information relating to the Practice as a business organisation. All such information from any source is to be regarded as strictly confidential.
Information relating to patients, carers, colleagues, other healthcare workers or the business of the Practice may only be divulged to authorised persons in accordance with the Practice policies and procedures relating to confidentiality and the protection of personal and sensitive data
Health & Safety:
The post-holder will assist in promoting and maintaining their own and others' health, safety and security as defined in the practice Health & Safety policy, the practice Health & Safety manual, and the practice Infection Control policy and published procedures. This will include:
Using personal security systems within the workplace according to practice guidelines
Identifying the risks involved in work activities and undertaking such activities in a way that manages those risks
Making effective use of training to update knowledge and skills
Using appropriate infection control procedures, maintaining work areas in a tidy and safe way and free from hazards
Actively reporting of health and safety hazards and infection hazards immediately when recognised
Keeping own work areas and general / patient areas generally clean, assisting in the maintenance of general standards of cleanliness consistent with the scope of the job holder's role
Undertaking periodic infection control training (minimum annually)
Reporting potential risks identified
Equality and Diversity
:
The post-holder will support the equality, diversity and rights of patients, carers and colleagues, to include acting in a way that recognizes the importance of people's rights, interpreting them in a way that is consistent with Practice procedures and policies, and current legislation. Respecting the privacy, dignity, needs and beliefs of patients, carers and colleagues. Behaving in a manner which is welcoming to and of the individual, is non-judgmental and respects their circumstances, feelings priorities and right.
Personal/Professional Development:
The post?holder will participate in all training programmes implemented by the Practice, including annual performance reviews and competency assessments, and will take responsibility for their own ongoing development, learning and performance.
They will maintain a comprehensive professional portfolio demonstrating autonomous clinical practice, clinical supervision, CPD and reflective learning, ensuring that clinical competencies required for safe autonomous practice in frailty care are continually met.
The post?holder will contribute to clinical governance activities such as audits, incident reviews and quality improvement initiatives, while engaging in regular clinical supervision and reflective discussions to support safe, accountable practice. They will also support the development of colleagues by sharing specialist frailty knowledge, offering mentorship and demonstrating skills and activities to others undertaking similar work
Quality:
The post-holder will strive to maintain quality within the Practice and will assess own performance and take accountability for own actions, either directly or under supervision. Contribute to the effectiveness of the team by reflecting on own and team activities and making suggestions on ways to improve and enhance the team's performance. Work effectively with individuals in other agencies to meet patients' needs. Effectively manage own time, workload and resources
Communication:
The post-holder should recognise the importance of effective communication within the team and will strive to communicate effectively with other team members, communicate effectively with patients and carers and recognise peoples' needs for alternative methods of communication and respond accordingly.
Person Specification
Qualifications- Essential
Master's degree in advanced clinical Practice
Registered Nurse on the NMC register
Non-medical prescriber
Qualifications- Desirable
Specialist knowledge within frailty
Digital Badge
Professional Knowledge & experience- Essential
Demonstrate high level of competence/advanced skills in clinical examination and diagnosis
Interpret pathology/radiology results/reports and action where appropriate
Excellent interpersonal and communication skills, providing enhanced discussions with patients and families regarding end of life wishes/planning
Familiar with the complex geriatric assessment, 4AT, GPCOG
Knowledge in EMIS clinical system
Knowledge of the Accurx system
Effective time management skills
Professional Knowledge & experience-Desirable
Experience of working in a primary care setting would be beneficial
Experience of working with frail/elderly patients at an advanced level
Personal skills and attributes- Essential
Advanced communication skills
Ability to work as an autonomous Practitioner
Able to work on own initiative
Must be personable, polite and approachable
Must be a team player
Must be adaptable to change
Commitment to ongoing training and education to develop clinical skills
Job related requirements- Essential
Have the ability to prioritise workload
Able to work under pressure and remain calm
Excellent attendance record
Full clean driving licence
Job Type: Full-time
Pay: 53,644.94-60,672.27 per year
Work Location: In person
Application deadline: 26/01/2026
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